Abstract
IntroductionThe short and intermediate term prognostic value of positron emission tomography Myocardial Perfusion Imaging (PET MPI) is well documented. The aim of this analysis is to describe the five-year prognostic value of PET MPI in consecutive patients undergoing 82-Rubidium PET MPI.MethodsA total of 747 consecutive patients with suspected or known coronary artery disease (CAD) underwent PET MPI in 2011 and 2012 and completed at least five year follow-up are included. The primary endpoint was a composite of cardiac death or nonfatal myocardial infarction (CDMI). Cox models were used to determine the five year independent prognostic predictors in this patient population.ResultsAt five years, a total of 75 CDMI (34 cardiac death and 45 nonfatal myocardial infarction) occurred. There was a gradual increase in event rate as the degree of perfusion defects increased (figure). Among the 259 patients without prior CAD, normal perfusion and ejection fraction, the five year CDMI event rate was 1.2%. Coronary flow reserve added incremental prognostic value over clinical variables (Increase in AUC from 0.792 to 0.807, p=0.02).ConclusionsAmong patients with suspected or known CAD, PET MPI adds long term incremental prognostic value. Patients without prior CAD, normal perfusion and ejection fraction have a very low five year event rate.